NPIMap

Organization Active NPI

Harmony Health Care Long Island

  • Federally Qualified Health Center (FQHC)
  • Elmont, NY
National Provider Identifier
1912211012
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
2908201R Issued in NY
Legal business name
HARMONY HEALTH CARE LONG ISLAND
Practice address
161 Hempstead Tpke
Elmont, NY 11003-1432
Phone
(516) 571-8200
Fax
(516) 571-8221
NPI assigned
Jul 30, 2010
Last updated
Feb 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Nemiroff
Title
Executive Director
Phone
(516) 546-4198

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 2908201R NY Primary

Addresses

Primary practice location

161 Hempstead Tpke
Elmont, NY 11003-1432

Mailing address

1600 Stewart Ave Ste 300
Westbury, NY 11590-6611

Other names 1

  • Long Island FQHC, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111212000065 NY Part B Supplier - Clinic/Group Practice 5991970535 Receives reassigned benefits from 104 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elmont, NY; Freeport, NY; Hempstead, NY; Oceanside, NY; Roosevelt, NY; Westbury, NY
O20120111000170 NY Part A Provider - Federally Qualified Health Center (FQHC) 5991970535 Practice locations: Elmont, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912211012. Details of each certification follow.

Federally qualified health center certification: CCN 331036

Legal name
HARMONY HEALTH CARE LONG ISLAND
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 21, 2012
Last certification
Feb 21, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 15, 2009 in NY
Enrollment address
161 Hempstead Tpke
Elmont, NY 11003-1432

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

400 Oak St
Ste 104
Garden City, NY 11530
Phone (516) 485-5975

682 Union Ave
Westbury, NY 11590
Phone (516) 571-9500

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Robert E Detor Individual Corporate DirectorBoard Member Jun 1, 2009
Savitree Pestano Individual Corporate DirectorChief Financial Official Mar 1, 2021 50%
W-2 Managing EmployeeChief Financial Official Mar 1, 2021
Stafford Byers Individual Corporate DirectorBoard Member Jan 1, 2017
Evelyn Lamoureux Individual Corporate OfficerBoard Member Jun 1, 2009
Gwen O'Shea Individual Corporate DirectorBoard Member Jun 1, 2009
Frank Piscetelli Individual Corporate DirectorChairperson of the Board Jan 1, 2021
Ann Hickson Individual Corporate DirectorBoard Member Jan 1, 2017
Elizabeth Rouse Individual Corporate DirectorBoard Member Jan 1, 2017
Lori Rung Individual Corporate DirectorDirector Board Member Jan 1, 2022
Jessica Sparrow Individual Corporate DirectorBoard Member Jun 1, 2009
David a Nemiroff Individual Corporate DirectorExecutive Director Jun 1, 2009 100%
W-2 Managing EmployeeExecutive Director Jun 1, 2009 50%
Marianela Casas Individual Corporate DirectorDirector Board Member Jan 1, 2022
Stacey Harley Individual W-2 Managing EmployeeChief Operating Official Jan 1, 2017

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1912211012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 STEWART AVE STE 300",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115906611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 HEMPSTEAD TPKE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110031432",
            "telephone_number": "516-571-8200",
            "fax_number": "516-571-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARMONY HEALTH CARE LONG ISLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-30",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "NEMIROFF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "516-546-4198"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": "2908201R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Island FQHC, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Elmont, NY

Sources for this page

Verify at the official NPI Registry.